Prevalence and Outcomes of Patients With Discordant High-Gradient Aortic Stenosis

Unger, Philippe; Powers, Andréanne; Le Nezet, Emma; Lacasse-Rioux, Emilie; Galloo, Xavier; Clavel, Marie-Annick

doi:10.1016/j.jacc.2024.01.025

Cited by 7 publications

(2 citation statements)

References 21 publications

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“…In these patients, reevaluation is recommended when SV and cardiac output are within normal limits. Following the exclusion of conditions associated with high flow, patients identified as having true DHG-AS exhibit a less favorable prognosis when compared to individuals with concordant moderate AS, with survival rates that closely resemble those observed in cases of true severe AS [ 26 ]. Recent studies [ 27 , 28 ] have indicated that DHG-AS is not uncommon, with a prevalence of 10% among patients with mean PG exceeding 40 mmHg.…”

Section: Diagnosismentioning

confidence: 99%

Unraveling the Enigma of Moderate Aortic Stenosis: Challenges and Future Prospects

Santangelo,

Tumminello,

Barbieri

et al. 2024

JCM

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According to current guidelines, only clinical surveillance is recommended for patients with moderate aortic valve stenosis (AS), while aortic valve replacement may be considered in patients undergoing surgery for other indications. Recent studies have shown that moderate AS is associated with a high risk of adverse cardiovascular events, including death, especially in patients with left ventricular dysfunction. In this context, multimodality imaging can help to improve the accuracy of moderate AS diagnosis and to assess left ventricular remodeling response. This review discusses the natural history of this valve disease and the role of multimodality imaging in the diagnostic process, summarizes current evidence on the medical and non-medical management, and highlights ongoing trials on valve replacement.

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Section: Diagnosismentioning

confidence: 99%

Unraveling the Enigma of Moderate Aortic Stenosis: Challenges and Future Prospects

Santangelo,

Tumminello,

Barbieri

et al. 2024

JCM

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“…If so, echocardiographic staging should be repeated if the cause is identified, reversible, and under control. In situations where the etiology of the high-output state is not reversible, AS should be classified as severe, placing the VMax–MG criterion ahead of AVA, since several studies have shown that the prognosis of these patients is similar to that of patients with high gradient AS and AVA < 1 cm 2 [ 66 ].…”

Section: Use Of Multimodality Cardiac Imaging In Challenging Casesmentioning

confidence: 99%

Diagnostic Challenges in Aortic Stenosis

González-García,

Pazos-López,

Calvo-Iglesias

et al. 2024

JCDD

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Aortic stenosis (AS) is the most prevalent degenerative valvular disease in western countries. Transthoracic echocardiography (TTE) is considered, nowadays, to be the main imaging technique for the work-up of AS due to high availability, safety, low cost, and excellent capacity to evaluate aortic valve (AV) morphology and function. Despite the diagnosis of AS being considered straightforward for a very long time, based on high gradients and reduced aortic valve area (AVA), many patients with AS represent a real dilemma for cardiologist. On the one hand, the acoustic window may be inadequate and the TTE limited in some cases. On the other hand, a growing body of evidence shows that patients with low gradients (due to systolic dysfunction, concentric hypertrophy or coexistence of another valve disease such as mitral stenosis or regurgitation) may develop severe AS (low-flow low-gradient severe AS) with a similar or even worse prognosis. The use of complementary imaging techniques such as transesophageal echocardiography (TEE), multidetector computed tomography (MDTC), or cardiac magnetic resonance (CMR) plays a key role in such scenarios. The aim of this review is to summarize the diagnostic challenges associated with patients with AS and the advantages of a comprehensive multimodality cardiac imaging (MCI) approach to reach a precise grading of the disease, a crucial factor to warrant an adequate management of patients.

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